Albumin/Creatinine Ratio for the Detection of Significant Proteinuria of Preeclampsia in Hospitalized Hypertensive Women |
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| Authors: | Camille Tourigny Evelyne Rey Julie Moreau Marie-Odile Guimond Annie Ouellet Jean Dubé Anne-Marie Côté |
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| Affiliation: | 1. Département de médecine, Université de Sherbrooke, Sherbrooke, QC;2. Département d''obstétrique-gynécologie and Centre de Recherche, CHU Sainte-Justine, Montréal, QC;3. Centre de recherche du CHUS, Sherbrooke, QC;4. Département d''obstétrique-gynécologie, CHUS, Sherbrooke, QC;5. Département de biochimie, CHUS, Sherbrooke, QC;1. Queen''s University Department of Obstetrics and Gynaecology, Kingston General Hospital, Kingston, ON;2. Queen''s University Department of Internal Medicine, Kingston General Hospital, Kingston, ON;3. University of British Columbia Division of Maternal-Fetal Medicine, BC Women''s Hospital, Vancouver, BC;1. Department of Family Practice, Faculty of Medicine, University of British Columbia, Vancouver, BC;2. Faculty of Medicine, University of British Columbia, Vancouver, BC;1. Program for Pregnancy and Postpartum Health, Neurovascular Health Lab, Faculty of Kinesiology, Sport, and Recreation, UniversitCof Alberta, Edmonton, AB;2. Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB;1. Peel Regional Cancer Center, Credit Valley Hospital, Mississauga, ON;2. Department of Obstetrics and Gynecology, Division of Gynecologic Oncology, University of Toronto, Toronto, ON;3. Department of Pathology, Toronto General Hospital/UHN, Toronto, ON;4. Anatomic Pathology, Surrey Memorial Hospital, Surrey, BC;5. Department of Gynecology Oncology, Princess Margaret Hospital/UHN, Toronto, ON;6. Odette Cancer Centre, Sunnybrook Health Sciences Centre, Toronto, ON |
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| Abstract: | ObjectivePreeclampsia is a hypertensive disorder of pregnancy associated with proteinuria detected by 24-hour urine collection (≥0.3 g/24 h) or protein/creatinine ratio (≥30 mg/mmol). The albumin/creatinine ratio (ACR) is used outside pregnancy to detect abnormal amounts of albumin in the urine, but there is little data on its value in pregnancy. Our objective was to determine the diagnostic threshold for ACR to detect significant proteinuria in women investigated for preeclampsia.MethodsA prospective observational study involving 99 hypertensive women (≥140/90 mm Hg) over 20 weeks gestation who were hospitalized at 2 Canadian tertiary centres. A 24-hour urine collection and a morning urine sample were collected. The optimal ACR threshold was determined by a receiver operating characteristic (ROC) curve using the 24-hour collection as the reference test; sensitivity and specificity analyses were performed. Maternal and perinatal characteristics were extracted from medical records.ResultsOf the 87 women who had completed urine collection, 74 (85%) had an initial diagnosis of preeclampsia and 63 (72%) had significant proteinuria confirmed by 24-hour collection. The area under the morning ROC curve was 0.92 (95% CI 0.86–0.98) and the optimal threshold obtained for the ACR was 9 mg/mmol, with a sensitivity and specificity of 84% (95% CI 73–92) and 88% (95% CI 68–97), respectively.ConclusionOur results suggest that an ACR threshold of 9 mg/mmol on a morning urine sample can be used to detect significant proteinuria of preeclampsia in hospitalized hypertensive women. |
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